Minimally invasive surgery (“MIS”) has been accepted as a useful alternative to open surgery for many health conditions. While safer for the patient, MIS poses a number of unique challenges to the surgeon performing them. The challenges fall into two broad domains: (i) the cognitive domain, wherein the surgeon uses knowledge and prior experience to make decisions regarding the procedure; and (ii) the motor control domain, where the surgeon uses physical skills to carry out specific decisions made through their cognitive process. For example, in laparoscopic surgery, a type of MIS, the surgery is conducted through small incisions made in the thorax or the abdomen of the body. Since the surgery takes place inside the closed volume of the human body, a small flexible camera called an endoscope is inserted inside the body to provide visual feedback. This set up gives rise to a number of cognitive challenges that make this form of surgery especially challenging, including:
(1) lack of visual feedback—the visual feedback is provided by images captured through the endoscope and displayed on a screen, lacking depth information;
(2) poor image quality—since the procedure is carried out within closed body cavities, the images received from the endoscope are affected by a number of factors, including improper lighting, smoke from cauterization of tissue and lensing effects;
(3) landmarks—Unlike open surgery, anatomical landmarks are not readily discernible and it is difficult to get oriented and navigate correctly inside the body without making mistakes; and
(4) patient differences—pathology and individual variations in physiology create visual differences in two bodies, this effect is amplified in MIS.
Some ramifications of the above described problems result in making the cognitive process of the surgeons exceedingly difficult. It is for the same reasons residents require extensive training with a number of procedures before they can graduate to performing surgery on their own.
Currently available simulators may train surgical residents for motor skill improvement. However, the current training methods do not adequately address the issue of improving the cognitive ability of the resident. Therefore, a resident typically gets acquainted with identifying anatomical landmarks by watching actual surgeries and training under a surgeon. This makes the learning curve slow, difficult, and expensive.
Accordingly, there is a need for an MIS training method and system that better prepares the operator by improving both the motor skills and the cognitive skills of the trainer.